Implantable devices formed on non-fouling methacrylate or acrylate polymers

ABSTRACT

Implantable devices formed of or coated with a material that includes a polymer having a non-fouling acrylate or methacrylate polymer are provided. The implantable device can be used for treating or preventing a disorder such as atherosclerosis, thrombosis, restenosis, hemorrhage, vascular dissection or perforation, vascular aneurysm, vulnerable plaque, chronic total occlusion, patent foramen ovale, claudication, anastomotic proliferation for vein and artificial grafts, bile duct obstruction, ureter obstruction, tumor obstruction, or combinations thereof.

CROSS-REFERENCE TO RELATED APPLICATION

This is a continuation-in-part application of U.S. application Ser. No.11/089,774, filed on Mar. 24, 2005, the teaching of which isincorporated herein in its entirety by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention generally relates to coatings or implantable devices,such as stents or coatings on a stent, formed of a material thatcontains methacrylates or acrylates having non-fouling pendant groups.

2. Description of the Background

Although stents work well mechanically, the chronic issues of restenosisand, to a lesser extent, stent thrombosis remain. Pharmacologicaltherapy in the form of a drug-delivery stent appears a feasible means totackle these biologically derived issues. Polymeric coatings placed ontothe stent serve to act both as the drug reservoir, and to control therelease of the drug. One of the commercially available polymer coatedproducts is stents manufactured by Boston Scientific. For example, U.S.Pat. Nos. 5,869,127; 6,099,563; 6,179,817; and 6,197,051, assigned toBoston Scientific Corporation, describe various compositions for coatingmedical devices. These compositions provide to stents described thereinan enhanced biocompatibility and may optionally include a bioactiveagent. U.S. Pat. No. 6,231,590 to Scimed Life Systems, Inc., describes acoating composition, which includes a bioactive agent, a collagenousmaterial, or a collagenous coating optionally containing or coated withother bioactive agents.

A current paradigm in biomaterials is the control of protein adsorptionon the implant surface. Uncontrolled protein adsorption, leading tomixed layer of partially denatured proteins, is a hallmark of currentbiomaterials when implanted. Such a surface presents different cellbinding sites from adsorbed plasma proteins such as fibrogen andimmunogloblulin G. Platelets and inflammatory cells such asmonocyte/macrophages and neutrophils adhere to these surfaces.Unfavorable events can be controlled by the use of non-fouling surfaces.These are materials, which absorb little or no protein, primarily due totheir hydrophilic surface properties.

Another limitation of current drug-delivery stents stems from the factthat the stent is a foreign body. Use of drug-delivery stents has provedsuccessful by use of controlled release of anti-proliferative oranti-inflammatory drugs to control restenosis. However, drug-deliverystents still have a small, but measurable, incidence of sub-acutethrombosis. Moreover, drug-delivery stents have not driven restenosis tozero levels, especially in more challenging patient subsets such asdiabetics or patients with small vessels, and/or long, diffuse lesions.A biomaterials-based strategy for further improving the outcome ofdrug-delivery stents is by the use of biobeneficial materials orsurfaces in stent coatings. A biobeneficial material is one whichenhances the biocompatibility of a device by being non-fouling,hemocompatible, actively non-thrombogenic, or anti-inflammatory, allwithout depending on the release of a pharmaceutically active agent.

Some of the currently used polymeric materials such as poly(vinylidenefluoride-co-hexafluoropropene) have good mechanical properties, andacceptable biocompatibility, but also have low permeability to drugs.One proposed solution to ameliorate this issue is to blend inhydrophilic polymers. However, it is well known in the art that manyhydrophilic materials such as polyethylene oxide or hyaluronic acid arewater-soluble and can be leached out of the composition such that thecoating may lose biobeneficiality. Such polymeric blends can also havecompromised mechanical properties, particularly the ultimate elongation.

The present invention addresses such problems by providing a polymericmaterial for coating implantable devices by providing polymericmaterials from which the device can be made.

SUMMARY OF THE INVENTION

Provided herein is a coating or implantable medical device formed of apolymer having non-fouling pendant groups.

In one embodiment, the polymer can be a polymer that contains repeatingunits of Formula I:

where:

R₁ and R₂ are independently H, C₁-C₄ alkyl, silyl groups, siloxy groups,or phenyl,

R₃, and R₄, R₅ are independently H, C₁-C₄ alkyl, silyl groups, siloxygroups, phenyl, poly(ethylene glycol) (PEG), polypropylene glycol), orpoly(alkylene oxide),

Z is O, S or NR₆ where R₆ is H, C₁-C₄ alkyl such as CH₃, ethyl, propyl,isopropyl, isobutyl, sec-butyl, or n-butyl, or phenyl,

X is absence, O, S, or NR₇ where R₇ is H, C₁-C₄ alkyl such as CH₃,ethyl, propyl, isopropyl, isobutyl, sec-butyl, or n-butyl, or phenyl,and

n is a positive integer ranging from, e.g., 1 to 100,000.

In some embodiments, in the polymer of formula I, where Z is O, X can beabsent, O, S, or NR₇ where R₇ is as defined above.

In some embodiments, in the polymer of formula I, where Z is S, X can beabsent, O, S, or NR₇ where R₇ is as defined above.

In some embodiments, in the polymer of formula I, where Z is NR₆, X canbe absent, O, S, or NR₇ where R₆ and R₇ are as defined above.

In some embodiments, in the polymer of formula I, where X is absent, Zis O, S or NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is O, Z is Sor NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is S, Z is O,S or NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is NR₇, Z isO, S or NR₆ where R₆ and R₇ are as defined above.

In some embodiments, in the polymer of formula I, where Z is NH, X isNH.

In some embodiments, in the polymer of formula I, where Z is S, X is S.

In some embodiments, in the polymer of Formula I, X is O.

The polymer disclosed herein containing units of formula I can be ahomopolymer or a copolymer. The copolymer can be statistical, random,alternating, period block or graft copolymer including the repeatingunits of Formula I and/or other repeating units such as a biocompatiblepolymer, and/or a biobeneficial material, both defined below.

The polymer defined herein can be used alone or in combination withanother biocompatible polymer and/or a biobeneficial material to formcoatings on implantable medical devices or to form the implantablemedical devices themselves. In some embodiments, the coatings or medicaldevices optionally include a bioactive agent.

The polymer or polymer blends described herein can be used to form acoating(s) on an implantable device. The polymers or polymer blendsdescribed herein can also be used to form the implantable device itself.The implantable device can optionally include a bioactive agent. Someexemplary bioactive agents are paclitaxel, docetaxel, estradiol, nitricoxide donors, super oxide dismutases, super oxide dismutases mimics,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO),tacrolimus, dexamethasone, rapamycin, rapamycin derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin,ABT-578, clobetasol, prodrugs thereof, co-drugs thereof, andcombinations thereof. The implantable device can be implanted in apatient to treat or prevent a disorder such as atherosclerosis,thrombosis, restenosis, hemorrhage, vascular dissection or perforation,vascular aneurysm, vulnerable plaque, chronic total occlusion,claudication, anastomotic proliferation for vein and artificial grafts,bile duct obstruction, ureter obstruction, tumor obstruction, orcombinations thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows the number of platelets adhered to the surface of apoly(methacrylate) polymer coating.

FIG. 2 shows the total amount of proteins from human plasma adsorbedonto the surface of a poly(methacrylate) polymer coating.

DETAILED DESCRIPTION

Provided herein is coating or implantable medical device formed of apolymer having non-fouling pendant groups. The polymer defined hereincan be used alone or in combination with another biocompatible polymerand/or a biobeneficial material to form coatings on implantable medicaldevices or to form the implantable medical devices themselves. In someembodiments, the coatings or medical devices optionally include abioactive agent. Some exemplary bioactive agents are paclitaxel,docetaxel, estradiol, nitric oxide donors, super oxide dismutases, superoxide dismutases mimics, 4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl(4-amino-TEMPO), tacrolimus, dexamethasone, rapamycin, rapamycinderivatives, 40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, 40-O-tetrazole-rapamycin,ABT-578, clobetasol, prodrugs thereof, co-drugs thereof, andcombinations thereof. The implantable device can be implanted in apatient to treat, prevent or ameliorate a disorder such asatherosclerosis, thrombosis, restenosis, hemorrhage, vascular dissectionor perforation, vascular aneurysm, vulnerable plaque, plaque rupture intype 2 diabetes, chronic total occlusion, claudication, anastomoticproliferation for vein and artificial grafts, bile duct obstruction,ureter obstruction, tumor obstruction, or combinations thereof.

Polymers Formed of Monomers Having Non-Fouling Pendant Groups

In one embodiment, the polymer can be a polymer that contains repeatingunits of Formula I:

where:

R₁ and R₂ are independently H, C₁-C₄ alkyl, silyl groups, siloxy groups,or phenyl,

R₃, and R₄, R₅ are independently H, C₁-C₄ alkyl, silyl groups, siloxygroups, phenyl, poly(ethylene glycol) (PEG), polypropylene glycol), orpoly(alkylene oxide),

Z is O, S or NR₆ where R₆ is H, C₁-C₄ alkyl such as CH₃, ethyl, propyl,isopropyl, isobutyl, sec-butyl, or n-butyl, or phenyl,

X is absence, O, S, or NR₇ where R₇ is H, C₁-C₄ alkyl such as CH₃,ethyl, propyl, isopropyl, isobutyl, sec-butyl, or n-butyl, or phenyl,and

n is a positive integer ranging from, e.g., 1 to 100,000.

In some embodiments, in the polymer of formula I, where Z is O, X can beabsent, O, S, or NR₇ where R₇ is as defined above.

In some embodiments, in the polymer of formula I, where Z is S, X can beabsent, O, S, or NR₇ where R₇ is as defined above.

In some embodiments, in the polymer of formula I, where Z is NR₆, X canbe absent, O, S, or NR₇ where R₆ and R₇ are as defined above.

In some embodiments, in the polymer of formula I, where X is absent, Zis O, S or NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is O, Z is Sor NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is S, Z is O,S or NR₆ where R₆ is as defined above.

In some embodiments, in the polymer of formula I, where X is NR₇, Z isO, S or NR₆ where R₆ and R₇ are as defined above.

In some embodiments, in the polymer of formula I, where Z is NH, X isNH.

In some embodiments, in the polymer of formula I, where Z is S, X is S.

In some embodiments, in the polymer of Formula I, X is O.

The polymer disclosed herein containing units of formula I can be ahomopolymer or a copolymer. The copolymer can be statistical, random,alternating, period block or graft copolymer including the repeatingunits of Formula I and/or other repeating units such as a biocompatiblepolymer, and/or a biobeneficial material, both defined below.

Some representative polymers of Formula I are: poly(2-methoxyethylacrylate) (PMEA), poly(2-hydroxyethyl acrylate) (PHEA), poly(ethylacrylate) (PEA), (poly(2-ethylhexyl acrylate) (PEHA),poly(2-phenoxyethyl acrylate) (PPEA), poly(2-ethoxyethyl acrylate)(PEEA), poly(2-hydroxyethyl methacrylate) (PHEMA), poly(2-methoxyethylmethacrylate) (PMEMA), poly(ethyl methacrylate) (PEMA),(poly(2-ethylhexyl methacrylate) (PEHMA), poly(2-phenoxyethylmethacrylate) (PPEMA), poly(hydroxypropyl methacrylamide),poly(2-ethoxyethyl methacrylate) (PEEM), and combinations thereof.

In some embodiments, R₁, R₂, R₃, R₄, R₅, Z and X of Formula I areselected to exclude from Formula I any of the methacrylate or acrylatepolymers described in the sections entitled “Polymer blends” or“Biobeneficial material”, below.

The polymers described herein can be synthesized by methods known in theart (see, for example, D. Braun, et al., Polymer Synthesis: Theory andPractice. Fundamentals, Methods, Experiments. 3^(rd) Ed., Springer,2001; Hans R. Kricheldorf, Handbook of Polymer Synthesis, Marcel DekkerInc., 1992; G. Odian, Principles of Polymerization, 3^(rd) ed. JohnWiley & Sons, 1991). For example, one method that can be used to makethe polymer can be free radical methods (see, for example, D. Braun, etal., Polymer Synthesis: Theory and Practice. Fundamentals, Methods,Experiments. 3^(rd) Ed., Springer, 2001; Hans R. Kricheldorf, Handbookof Polymer Synthesis, Marcel Dekker Inc., 1992). Polymerization bysuspension or emulsion techniques utilizing free radical initiation iscommonly employed. Block copolymers and terpolymers can be produced byatom transfer polymerization. Polymerization in solvent can also be usedto synthesize the polymers described herein.

Polymer Blends or Conjugation

In another embodiment, the polymers described herein can be blended withone or more additional biocompatible polymers having differenthydrophilicity and/or flexibility to generate a polymer blend coatingmaterial that has desired biocompatibility, flexibility and drugpermeability. In other embodiments, the polymers of the presentinvention can be bonded, conjugated, grafted or crosslinked with one ormore additional biocompatible polymers. In some embodiments, thepolymers can be coated in separate layers.

The additional biocompatible polymer can be biodegradable (bothbioerodable or bioabsorbable) or nondegradable, and can be hydrophilicor hydrophobic. In some embodiments, hydrophilic is defined to have aHildebrand solubility parameter δ value greater than about 8.5(cal/cm³)^(1/2), e.g., greater than about 9.5 (cal/cm³)^(1/2), greaterthan about 10.5 (cal/cm³)^(1/2) or about 11.5 (cal/cm³)^(1/2). The δ isdetermined by the following equation:

δ=(ΔE/V)^(1/2)

where ΔE is the energy of vaporization, cal/mole, and V is the molarvolume, cm³/mole.

Representative biocompatible polymers include, but are not limited to,poly(ester amide), polyhydroxyalkanoates (PHA),poly(3-hydroxyalkanoates) such as poly(3-hydroxypropanoate),poly(3-hydroxybutyrate), poly(3-hydroxyvalerate),poly(3-hydroxyhexanoate), poly(3-hydroxyheptanoate) andpoly(3-hydroxyoctanoate), poly(4-hydroxyalkanoate) such aspoly(4-hydroxybutyrate), poly(4-hydroxyvalerate),poly(4-hydroxyhexanoate), poly(4-hydroxyheptanoate),poly(4-hydroxyoctanoate) and copolymers including any of the3-hydroxyalkanoate or 4-hydroxyalkanoate monomers or blends thereof,poly polyesters, poly(D,L-lactide), poly(L-lactide), polyglycolide,poly(D,L-lactide-co-glycolide), poly(L-lactide-co-glycolide),polycaprolactone, poly(lactide-co-caprolactone),poly(glycolide-co-caprolactone), poly(dioxanone), poly(ortho esters),poly(anhydrides), poly(tyrosine carbonates) and derivatives thereof,poly(tyrosine ester) and derivatives thereof, poly(imino carbonates),poly(glycolic acid-co-trimethylene carbonate), polyphosphoester,polyphosphoester urethane, poly(amino acids), polycyanoacrylates,poly(trimethylene carbonate), poly(iminocarbonate), polyurethanes,polyphosphazenes, silicones, polyesters, polyolefins, polyisobutyleneand ethylene-alphaolefin copolymers, acrylic polymers and copolymers,vinyl halide polymers and copolymers, such as polyvinyl chloride,polyvinyl ethers, such as polyvinyl methyl ether, polyvinylidenehalides, such as polyvinylidene chloride, polyacrylonitrile, polyvinylketones, polyvinyl aromatics, such as polystyrene, polyvinyl esters,such as polyvinyl acetate, copolymers of vinyl monomers with each otherand olefins, such as ethylene-methyl methacrylate copolymers,acrylonitrile-styrene copolymers, ABS resins, and ethylene-vinyl acetatecopolymers, polyamides, such as Nylon 66 and polycaprolactam, alkydresins, polycarbonates, polyoxymethylenes, polyimides, polyethers,poly(glyceryl sebacate), poly(propylene fumarate), epoxy resins,polyurethanes, rayon, rayon-triacetate, cellulose acetate, cellulosebutyrate, cellulose acetate butyrate, cellophane, cellulose nitrate,cellulose propionate, cellulose ethers, carboxymethyl cellulose,polyethers such as poly(ethylene glycol) (PEG), copoly(ether-esters)(e.g. poly(ethylene oxide/poly(lactic acid) (PEO/PLA)), polyalkyleneoxides such as poly(ethylene oxide), poly(propylene oxide), poly(etherester), polyalkylene oxalates, polyphosphazenes, phosphoryl choline,choline, poly(aspirin), polymers and co-polymers of hydroxyl bearingmonomers other than the polymers of Formula I (defined above), PEGacrylate (PEGA), PEG methacrylate,2-methacryloyloxyethylphosphorylcholine (MPC) and n-vinyl pyrrolidone(VP), carboxylic acid bearing monomers such as methacrylic acid (MA),acrylic acid (AA), alkoxymethacrylate, alkoxyacrylate, and3-trimethylsilylpropyl methacrylate (TMSPMA),poly(styrene-isoprene-styrene)-PEG (SIS-PEG), polystyrene-PEG,polyisobutylene-PEG, polycaprolactone-PEG (PCL-PEG), PLA-PEG,poly(methyl methacrylate)-PEG (PMMA-PEG), polydimethylsiloxane-co-PEG(PDMS-PEG), poly(vinylidene fluoride)-PEG (PVDF-PEG), PLURONIC™surfactants (polypropylene oxide-co-polyethylene glycol),poly(tetramethylene glycol), hydroxy functional poly(vinyl pyrrolidone),biomolecules such as collagen, alginate, fibrin, fibrinogen, albumin,cellulose, starch, collagen, dextran, dextrin, fragments and derivativesof hyaluronic acid, heparin, fragments and derivatives of heparin,glycosamino glycan (GAG), GAG derivatives, polysaccharide, elastin,chitosan, alginate, and combinations thereof. In some embodiments, thepolymer can exclude any one of the aforementioned polymers.

As used herein, the terms poly(D,L-lactide), poly(L-lactide),poly(D,L-lactide-co-glycolide), and poly(L-lactide-co-glycolide) can beused interchangeably with the terms poly(D,L-lactic acid), poly(L-lacticacid), poly(D,L-lactic acid-co-glycolic acid), and poly(L-lacticacid-co-glycolic acid), respectively.

Biobeneficial Material

The polymers or polymer blends described herein may form a coating on animplantable device such as a stent or form the implantable device suchas the stent optionally with a biobeneficial material. The combinationcan be mixed, blended, bonded, conjugated, crosslinked, grafted, orcoated in separate layers. In some embodiments, it can be aninterpenetrating polymer network (IPN). The biobeneficial materialuseful in the coatings described herein can be a polymeric material ornon-polymeric material. The biobeneficial material is preferablynon-toxic, non-antigenic and non-immunogenic. A biobeneficial materialis one which enhances the biocompatibility of a device by beingnon-fouling, hemocompatible, actively non-thrombogenic, oranti-inflammatory, all without depending on the release of apharmaceutically active agent.

Representative biobeneficial materials include, but are not limited to,polyethers such as poly(ethylene glycol), copoly(ether-esters) (e.g.PEO/PLA); polyalkylene oxides such as poly(ethylene oxide),poly(propylene oxide), poly(ether ester), polyalkylene oxalates,polyphosphazenes, phosphoryl choline, choline, poly(aspirin), polymersand co-polymers of hydroxyl bearing monomers such as hydroxyethylmethacrylate (HEMA), hydroxypropyl methacrylate (HPMA),hydroxypropylmethacrylamide, poly (ethylene glycol) acrylate (PEGA), PEGmethacrylate, 2-methacryloyloxyethylphosphorylcholine (MPC) and n-vinylpyrrolidone (VP), carboxylic acid bearing monomers such as methacrylicacid (MA), acrylic acid (AA), alkoxymethacrylate, alkoxyacrylate, and3-trimethylsilylpropyl methacrylate (TMSPMA),poly(styrene-isoprene-styrene)-PEG (SIS-PEG), polystyrene-PEG,polyisobutylene-PEG, polycaprolactone-PEG (PCL-PEG), PLA-PEG,poly(methyl methacrylate)-PEG (PMMA-PEG), polydimethylsiloxane-co-PEG(PDMS-PEG), poly(vinylidene fluoride)-PEG (PVDF-PEG), PLURONIC™surfactants (polypropylene oxide-co-polyethylene glycol),poly(tetramethylene glycol), hydroxy functional poly(vinyl pyrrolidone),biomolecules such as fibrin, fibrinogen, albumin, cellulose, starch,collagen, dextran, dextrin, hyaluronic acid, fragments and derivativesof hyaluronic acid, heparin, fragments and derivatives of heparin,glycosamino glycan (GAG), GAG derivatives, polysaccharide, elastin,chitosan, alginate, silicones, PolyActive™, and combinations thereof. Insome embodiments, the coating can exclude any one of the aforementionedpolymers.

The term PolyActive™ refers to a block copolymer having flexiblepoly(ethylene glycol) and poly(butylene terephthalate) blocks(PEGT/PBT). PolyActive™ is intended to include AB, ABA, BAB copolymershaving such segments of PEG and PBT (e.g., poly(ethyleneglycol)-block-poly(butyleneterephthalate)-block poly(ethylene glycol)(PEG-PBT-PEG).

In a preferred embodiment, the biobeneficial material can be a polyethersuch as poly (ethylene glycol) (PEG) or polyalkylene oxide.

Bioactive Agents

The polymer of Formula I or a polymer blend or conjugation (e.g., bondedor grafted) having the polymer of Formula I may form a coating or animplantable device optionally with one or more bioactive agents. Thesebioactive agents can be any agent which can be a therapeutic,prophylactic, ameliorative or diagnostic agent. These agents can haveanti-proliferative or anti-inflammatory properties or can have otherproperties such as antineoplastic, antiplatelet, anti-coagulant,anti-fibrin, antithrombonic, antimitotic, antibiotic, antiallergic,antioxidant as well as cystostatic agents. Examples of suitabletherapeutic, prophylactic or ameliorative agents include syntheticinorganic and organic compounds, proteins and peptides, polysaccharidesand other sugars, lipids, and DNA and RNA nucleic acid sequences havingtherapeutic, prophylactic or diagnostic activities. Nucleic acidsequences include genes, antisense molecules which bind to complementaryDNA to inhibit transcription, and ribozymes. Some other examples ofother bioactive agents include antibodies, receptor ligands, enzymes,adhesion peptides, blood clotting factors, inhibitors or clot dissolvingagents such as streptokinase and tissue plasminogen activator, antigensfor immunization, hormones and growth factors, oligonucleotides such asantisense oligonucleotides and ribozymes and retroviral vectors for usein gene therapy. Examples of anti-proliferative agents include rapamycinand its functional or structural derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus), and its functional orstructural derivatives, and paclitaxel and its functional and structuralderivatives. Examples of rapamycin derivatives include40-epi-(N1-tetrazolyl)-rapamycin (ABT-578),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin.Examples of paclitaxel derivatives include docetaxel. Examples ofantineoplastics and/or antimitotics include methotrexate, azathioprine,vincristine, vinblastine, fluorouracil, doxorubicin hydrochloride (e.g.Adriamycin® from Pharmacia & Upjohn, Peapack N.J.), and mitomycin (e.g.Mutamycin® from Bristol-Myers Squibb Co., Stamford, Conn.). Examples ofsuch antiplatelets, anticoagulants, antifibrin, and antithrombinsinclude sodium heparin, low molecular weight heparins, heparinoids,hirudin, argatroban, forskolin, vapiprost, prostacyclin and prostacyclinanalogues, dextran, D-phe-pro-arg-chloromethylketone (syntheticantithrombin), dipyridamole, glycoprotein IIb/IIIa platelet membranereceptor antagonist antibody, recombinant hirudin, thrombin inhibitorssuch as Angiomax ä (Biogen, Inc., Cambridge, Mass.), calcium channelblockers (such as nifedipine), colchicine, fibroblast growth factor(FGF) antagonists, fish oil (omega 3-fatty acid), histamine antagonists,lovastatin (an inhibitor of HMG-CoA reductase, a cholesterol loweringdrug, brand name Mevacor® from Merck & Co., Inc., Whitehouse Station,N.J.), monoclonal antibodies (such as those specific forPlatelet-Derived Growth Factor (PDGF) receptors), nitroprusside,phosphodiesterase inhibitors, prostaglandin inhibitors, suramin,serotonin blockers, steroids, thioprotease inhibitors,triazolopyrimidine (a PDGF antagonist), nitric oxide or nitric oxidedonors, super oxide dismutases, super oxide dismutase mimetic,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO), estradiol,anticancer agents, dietary supplements such as various vitamins, and acombination thereof. Examples of anti-inflammatory agents includingsteroidal and non-steroidal anti-inflammatory agents include tacrolimus,dexamethasone, clobetasol, combinations thereof. Examples of suchcytostatic substance include angiopeptin, angiotensin converting enzymeinhibitors such as captopril (e.g. Capoten® and Capozide® fromBristol-Myers Squibb Co., Stamford, Conn.), cilazapril or lisinopril(e.g. Prinivil® and Prinzide® from Merck & Co., Inc., WhitehouseStation, N.J.). An example of an antiallergic agent is permirolastpotassium. Other therapeutic substances or agents which may beappropriate include midostaurin, pimecrolimus, imatinib mesylate,alpha-interferon, bioactive RGD, and genetically engineered epithelialcells. The foregoing substances can also be used in the form of prodrugsor co-drugs thereof. The foregoing substances are listed by way ofexample and are not meant to be limiting. Other active agents which arecurrently available or that may be developed in the future are equallyapplicable.

The dosage or concentration of the bioactive agent required to produce afavorable therapeutic effect should be less than the level at which thebioactive agent produces toxic effects and greater than the level atwhich non-therapeutic results are obtained. The dosage or concentrationof the bioactive agent can depend upon factors such as the particularcircumstances of the patient; the nature of the trauma; the nature ofthe therapy desired; the time over which the ingredient administeredresides at the vascular site; and if other active agents are employed,the nature and type of the substance or combination of substances.Therapeutic effective dosages can be determined empirically, for exampleby infusing vessels from suitable animal model systems and usingimmunohistochemical, fluorescent or electron microscopy methods todetect the agent and its effects, or by conducting suitable in vitrostudies. Standard pharmacological test procedures to determine dosagesare understood by one of ordinary skill in the art.

Examples of Implantable Device

As used herein, an implantable device may be any suitable medicalsubstrate that can be implanted in a human or veterinary patient.Examples of such implantable devices include self-expandable stents,balloon-expandable stents, stent-grafts, grafts (e.g., aortic grafts),artificial heart valves, cerebrospinal fluid shunts, pacemakerelectrodes, and endocardial leads (e.g., FINELINE and ENDOTAK, availablefrom Guidant Corporation, Santa Clara, Calif.). The underlying structureof the device can be of virtually any design. The device can be made ofa metallic material or an alloy such as, but not limited to, cobaltchromium alloy (ELGILOY), stainless steel (316L), high nitrogenstainless steel, e.g., BIODUR 108, cobalt chrome alloy L-605, “MP35N,”“MP20N,” ELASTINITE (Nitinol), tantalum, nickel-titanium alloy,platinum-iridium alloy, gold, magnesium, or combinations thereof “MP35N”and “MP20N” are trade names for alloys of cobalt, nickel, chromium andmolybdenum available from Standard Press Steel Co., Jenkintown, Pa.“MP35N” consists of 35% cobalt, 35% nickel, 20% chromium, and 10%molybdenum. “MP20N” consists of 50% cobalt, 20% nickel, 20% chromium,and 10% molybdenum. Devices made from bioabsorbable or biostablepolymers could also be used with the embodiments of the presentinvention. The device itself, such as a stent, can also be made from thedescribed inventive polymers or polymer blends.

Method of Use

In accordance with embodiments of the invention, a coating of thevarious described embodiments can be formed on an implantable device orprosthesis, e.g., a stent. For coatings including one or more activeagents, the agent will retain on the medical device such as a stentduring delivery and expansion of the device, and released at a desiredrate and for a predetermined duration of time at the site ofimplantation. In accordance with some other embodiments of theinvention, bioabsorbable or non-degradable devices can be formed of amaterial containing the polymer of Formula I. The material can be thepolymer of Formula I or a polymer blend containing the polymer ofFormula I with one or more biocompatible polymers, optionally with abiobeneficial material and/or a bioactive agents, which are definedabove. Preferably, the medical device is a stent. A stent having theabove-described coating is useful for a variety of medical procedures,including, by way of example, treatment of obstructions caused by tumorsin bile ducts, esophagus, trachea/bronchi and other biologicalpassageways. A stent having the above-described coating is particularlyuseful for treating occluded regions of blood vessels caused by abnormalor inappropriate migration and proliferation of smooth muscle cells,thrombosis, and restenosis. Stents may be placed in a wide array ofblood vessels, both arteries and veins. Representative examples of sitesinclude the iliac, renal, and coronary arteries.

For implantation of a stent, an angiogram is first performed todetermine the appropriate positioning for stent therapy. An angiogram istypically accomplished by injecting a radiopaque contrasting agentthrough a catheter inserted into an artery or vein as an x-ray is taken.A guidewire is then advanced through the lesion or proposed site oftreatment. Over the guidewire is passed a delivery catheter, whichallows a stent in its collapsed configuration to be inserted into thepassageway. The delivery catheter is inserted either percutaneously orby surgery into the femoral artery, brachial artery, femoral vein, orbrachial vein, and advanced into the appropriate blood vessel bysteering the catheter through the vascular system under fluoroscopicguidance. A stent having the above-described coating may then beexpanded at the desired area of treatment. A post-insertion angiogrammay also be utilized to confirm appropriate positioning.

EXAMPLES

The embodiments of the present invention will be illustrated by thefollowing set forth examples. All parameters and data are not to beconstrued to unduly limit the scope of the embodiments of the invention.

Example 1 Hemocompatibility Study of poly(2-methoxyethyl acrylate)(PMEA)

The measures of in vitro hemocompatibility, including human plateletadhesion, changes in platelet morphology, total absorbed protein fromhuman plasma, amount of absorbed BSA (bovine serum albumin), absorbedhuman fibrinogen, and changes in protein conformation by circulardichroism of polymers PPEA, PEHA, PEA, PMEA, PHEMA and PHEA weremeasured (see M, Tanaka M, et al., Biomaterials 21:1471-1481 (2000)).FIG. 1 shows number of platelets adhered to the surface of the polymers(**P<0.01 vs. PMEA, mean±SD, n=5), and FIG. 2 shows the total amount ofproteins from human plasma adsorbed onto polymers (*P<0.05 vs. PMEA;**P<0.01 vs. PMEA, mean±SD, n=5). In this statistical analysis, the Pvalue comes from hypothesis testing to determine if, in fact, the levelsof protein absorption between the various polymers are equivalent (nullhypothesis). Here, P is the probability, on a scale of zero to one, ofwrongly rejecting the null hypothesis if it is in fact true.Consequently, P<0.05 means there is less than a 5% chance that thedifference seen between the two groups was caused by sampling error.This is often restated to mean there is a 95% confidence that the twogroups are different.

As can be seen, the PMEA coating has both the lowest number of plateletsabsorbed and the lowest plasma protein absorption of the polymerstested.

Example 2 Fabrication of a Polymer-Coated Implantable Medical Device

Primer Layer

Poly(n-butyl methacrylate) is dissolved in 1:1 acetone:xylene (byweight) to give a 2% by weight solution. An EFD 780S spray nozzle with aVALVEMATE 7040 control system, manufactured by EFD, Inc., EastProvidence, R.I. is used to spray the polymer solution onto a stent.During the process of applying the composition, the stent can beoptionally rotated about its longitudinal axis, at a speed of 50 toabout 150 rpm. The stent can also be linearly moved along the same axisduring the application.

The 2% solution of the polymer is applied to a 12-mm VISION™ stent(available from Guidant Corporation) in a series of 10-second passes, todeposit 10 μg of coating per spray pass. Between the spray passes, thestent is dried for 10 seconds using a flow of air at 80° C. Five spraypasses are applied to form a 50 μg primer layer, followed by baking theprimer layer at 80° C. for one hour.

Drug-Containing Layer

A mixture is prepared that consists of, by weight, 2% of poly(n-butylmethacrylate), 1.0% of everolimus, and 97% of the 1:1 (by weight)acetone:cyclohexanone. The same apparatus used to spray the primer layeron the stent is used to apply the drug layer. 10 spray passes areperformed to form a 175 μg drug-polymer layer, followed by drying thedrug-polymer layer at 50° C. for 1 hour.

Biobeneficial Topcoat Layer

A topcoat layer comprising, by weight, 2% poly(2-methoxyethyl acrylate)and 98% 60:40 acetone:cyclohexanone is then applied over thedrug-containing layer using the same apparatus used to coat the primerlayer and the drug-containing layer. Six spray passes are performed toform a 100 μg topcoat layer, followed by drying at 50° C. for 1 hour.

While particular embodiments of the present invention have been shownand described, it will be obvious to those skilled in the art thatchanges and modifications can be made without departing from thisinvention in its broader aspects. Therefore, the appended claims are toencompass within their scope all such changes and modifications as fallwithin the true spirit and scope of this invention.

1. An implantable device having a coating comprising a polymer thatcomprises repeating units of Formula I:

wherein: R₁ and R₂ are independently H, C₁-C₄ alkyl, silyl groups,siloxy groups, or phenyl, R₃, and R₄, R₅ are independently H, C₁-C₄alkyl, silyl groups, siloxy groups, phenyl, poly(ethylene glycol) (PEG),polypropylene glycol), or poly(alkylene oxide), Z is O, S or NR₆ whereR₆ is H, CH₃, ethyl, propyl, isopropyl, isobutyl, sec-butyl, n-butyl, orphenyl, X is absence, O, S, or NR₇ where R₇ is H, CH₃, ethyl, propyl,isopropyl, isobutyl, sec-butyl, n-butyl, or phenyl, and n is a positiveinteger ranging from 1 to 100,000.
 2. The implantable device of claim 1,wherein Z is O.
 3. The implantable device of claim 1, wherein Z is S. 4.The implantable device of claim 1, wherein Z is NR₆ where R₆ is H, CH₃,ethyl, propyl, isopropyl, isobutyl, sec-butyl, n-butyl, or phenyl. 5.The implantable device of claim 1, wherein: X is absent; and Z is S orNR₆ where R₆ is H, CH₃, ethyl, propyl, isopropyl, isobutyl, sec-butyl,n-butyl, or phenyl.
 6. The implantable device of claim 1, wherein: X isO; and Z is S or NR₆ where R₆ is H, CH₃, ethyl, propyl, isopropyl,isobutyl, sec-butyl, n-butyl, or phenyl.
 7. The implantable device ofclaim 1, wherein: X is S; and Z is O, S or NR₆ where R₆ is H, CH₃,ethyl, propyl, isopropyl, isobutyl, sec-butyl, n-butyl, or phenyl. 8.The implantable device of claim 1, wherein: X is NR₇; Z is O, S or NR₆;and where R₆ and R₇ are independently H, CH₃, ethyl, propyl, isopropyl,isobutyl, sec-butyl, n-butyl, or phenyl.
 9. The implantable device ofclaim 1, wherein: Z is NH; and X is NH.
 10. The implantable device ofclaim 1, wherein: Z is S; and X is S.
 11. The implantable device ofclaim 1, wherein: R₃, and R₄, R₅ are independently H, CH₃, ethyl,propyl, isopropyl, isobutyl, sec-butyl, n-butyl, or phenyl, silylgroups, siloxy groups, phenyl, poly(ethylene glycol) (PEG),polypropylene glycol), or poly(alkylene oxide).
 12. The implantabledevice of claim 1, wherein: R₃, and R₄ are independently H and CH₃; andR₅ is silyl groups, siloxy groups, phenyl, poly(ethylene glycol) (PEG),poly(propylene glycol), or poly(alkylene oxide).
 13. The implantabledevice of claim 1, further comprising a bioactive agent.
 14. Theimplantable device of claim 9, wherein the bioactive agent is selectedfrom the group consisting of paclitaxel, docetaxel, estradiol, nitricoxide donors, super oxide dismutases, super oxide dismutases mimics,4-amino-2,2,6,6-tetramethylpiperidine-1-oxyl (4-amino-TEMPO),tacrolimus, dexamethasone, rapamycin, rapamycin derivatives,40-O-(2-hydroxy)ethyl-rapamycin (everolimus),40-O-(3-hydroxy)propyl-rapamycin,40-O-[2-(2-hydroxy)ethoxy]ethyl-rapamycin, and 40-O-tetrazole-rapamycin,ABT-578, clobetasol, prodrugs thereof, co-drugs thereof, and acombination thereof.
 15. The implantable device of claim 1 which is astent.
 16. The implantable device of claim 7, which is a stent.
 17. Amethod of fabricating an implantable device, comprising forming on theimplantable device a coating according to claim
 1. 18. A method oftreating a disorder in a patient comprising implanting in the patientthe implantable device of claim 1, wherein the disorder is selected fromthe group consisting of atherosclerosis, thrombosis, restenosis,hemorrhage, vascular dissection or perforation, vascular aneurysm,vulnerable plaque, chronic total occlusion, patent foramen ovale,claudication, anastomotic proliferation for vein and artificial grafts,bile duct obstruction, ureter obstruction, tumor obstruction, andcombinations thereof.